Westside Pediatric Dentistry

Many people question why the primary or “baby” teeth need to be repaired when they will ultimately fall out at some point, being replaced by permanent teeth. Though the front teeth, or incisors, are usually replaced by the permanent teeth usually by the age of seven, the molars which are at higher risk are often not replaced until around the age of twelve. During that time any untreated cavities could progress leading to possible pain, infection or early tooth loss. When a tooth is lost before the permanent tooth is ready to erupt it can lead to a loss of space, creating an issue for there being insufficient room for the new tooth to erupt. If this occurs orthodontics may be required for braces to be used to create space or that permanent tooth may require removal as well.

Although all dentist receive training on evaluation of dental diseases and some growth and development, a pediatric dentist trains for an additional two to three years to learn how to evaluate concerns specific to children and young adults. The training they receive also allows them to perform necessary procedures on children to make it as comfortable as possible when it comes to patient management. Most pediatric dental offices have an environment that is more child friendly with games and other items to entertain children as they wait for their appointment, easing any apprehension a child may have about their appointment. Additionally the staff that works at pediatric offices are comfortable interacting with children and help to provide a happy, child friendly environment.

Cavities are the result of a specific bacteria using carbohydrates to convert to an acid that breaks down the enamel on teeth. Many times it may start as a small white spot on a tooth, and is often not visible in between teeth without the use of an x-ray. If left untreated the cavity will continue through that outer layer of the tooth until it reaches the next layer, dentin. Dentin is significantly softer than enamel and once the cavity reaches this area it can advance more quickly. This will lead to more breakdown of the tooth with risk of reaching the nerve and causing an infection, or a weakening of the tooth leading to fractures. The best way to avoid cavities is to avoid frequent exposure to food or drink high in carbohydrate such as juices, candy, pretzels, chips, crackers, and dry cereal. The use of floss to remove the bacteria between the teeth is important and brushing with a fluoride containing toothpaste serves to both kill the bacteria and strengthen the tooth.

The removal of wisdom teeth is determined based on the amount of room available for eruption in each patient’s mouth. Some people will actually have a large enough jaw to allow the eruption of these molars, and with proper hygiene they can remain there for the lifetime of the patient, though it requires effort as they’re so far back. Many people will have the wisdom teeth erupting at an angle that can cause damage to other teeth and they should be removed before that becomes an issue. This is evaluated by taking a panoramic x-ray. There are others who the teeth are impacted and will not erupt in the mouth. Although the risk of complication from these are rare, it is often recommended to have them removed as pathology such as cysts may form around them as the patient ages. For most patients the recovery from these surgeries are a few days.

The age is dependent on the growth and development of the child. Many times orthodontic evaluation is determined by the eruption of the permanent teeth, though patients with issues in the growth of their jaws may be seen earlier. Your dentist may recommend evaluation in severe cases of space loss or jaw growth issues as early as six years old, however most patients will not be sent until they begin losing their baby molars and canines which for most is between 11-13 years old. A pediatric dentist receives additional training in evaluation of growth and development, so they are well prepared to help decide when is the best time to see an orthodontist when monitored and six month recall appointments.

A sealant is a protective coating that is placed on the permanent molars to reduce the risk of cavities. The risk of cavities on the back molars is very high due to the deep developmental grooves in those teeth. The process involves cleaning the groves of the teeth and using a bonding material painted on the tooth followed by the application of a material that will stick to that tooth. A high intensity blue light is used to make the material hard. The patient is able to eat or drink right away. Most insurances cover all or a portion of this procedure. The sealants will be evaluated at each subsequent dental appointment to evaluate their integrity as they can break down over time, requiring replacement at times. Most sealants will last 5-10 years or longer depending on the habits of the patient.

Yes, the American Association of Pediatric Dentistry recommends bitewing x-rays every 12-18 months once the molars in the back of the patient’s mouth are closed to evaluate for cavities. This occurs often between the ages of five and four years old. It is additionally recommended that a panoramic x-ray is taken around the age of six when the permanent teeth start to erupt to evaluate the eruption of teeth and to rule out any development issues. The panoramic x-ray is usually repeated every five years, and that coordinates to the time in which the patient will be evaluated for braces. Most insurances cover part of or all of the cost of x-rays depending on your plan.

The treatment involved is modified for the ability of the patient to cooperate. For patients between 1-3 many times an oral exam is performed knee to knee evaluation, the parent holds on to the child with the patient on a cushion allowing the dentist to inspect the teeth and oral tissue, followed by a fluoride application. For patients that are older, an examination as well as cleaning is performed with a motorized toothbrush and the use of an instrument to remove any tartar followed by a fluoride application. Depending on the growth and development of the child, x-rays may also be taken to evaluate for cavities or a panoramic x-ray to monitor the eruption of teeth.

It is recommended that children see the dentist by the age of one year old. But if there are concerns about teeth that have erupted early, the dentist could be seen to monitor their eruption.